Rinaldo De Agostino1, Barbara Federspiel1, Evaldas Cesnulis2, Peter S Sandor3. 1. Department of Internal Medicine and Pain Clinic, SeeSpital, Horgen, Switzerland. 2. Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland. 3. ANNR RehaClinic, Kantonsspital Baden, CH-5404, Baden, Switzerland.
Abstract
OBJECTIVES: High-cervical spinal cord stimulation (SCS) is a promising neurostimulation method for the control of chronic pain, including chronic cluster headache. The effects of high-cervical SCS in patients with intractable chronic migraine pain are unknown. MATERIALS AND METHODS: This study is a retrospective survey of a cohort of 17 consecutive patients with medically intractable chronic migraine pain implanted with a high-cervical SCS device between 2007 and 2011. RESULTS: After a median of 15 months (range 2-48) since implantation, mean pain intensity was significantly reduced by 60% (p < 0.0001), with 71% of the patients experiencing a decrease of 50% or more. The median number of days with migraine decreased from 28 (range 12-28) to 9.0 (range 0-28) days (p = 0.0313). Quality of life was significantly improved (p = 0.0006), and the proportion of patients not requiring pain medication increased from 0.0% to 37.5% (p = 0.0313). Use of pharmacological and nonpharmacological treatments of migraine was decreased. Working capacity was not significantly improved. Complications were infrequent: three infections (13.0% of all implanted) and three lead dislocations (17.6% of all included). CONCLUSION: In patients with intractable chronic migraine treated with high-cervical SCS, pain and quality of life significantly improved, warranting further research.
OBJECTIVES: High-cervical spinal cord stimulation (SCS) is a promising neurostimulation method for the control of chronic pain, including chronic cluster headache. The effects of high-cervical SCS in patients with intractable chronic migraine pain are unknown. MATERIALS AND METHODS: This study is a retrospective survey of a cohort of 17 consecutive patients with medically intractable chronic migraine pain implanted with a high-cervical SCS device between 2007 and 2011. RESULTS: After a median of 15 months (range 2-48) since implantation, mean pain intensity was significantly reduced by 60% (p < 0.0001), with 71% of the patients experiencing a decrease of 50% or more. The median number of days with migraine decreased from 28 (range 12-28) to 9.0 (range 0-28) days (p = 0.0313). Quality of life was significantly improved (p = 0.0006), and the proportion of patients not requiring pain medication increased from 0.0% to 37.5% (p = 0.0313). Use of pharmacological and nonpharmacological treatments of migraine was decreased. Working capacity was not significantly improved. Complications were infrequent: three infections (13.0% of all implanted) and three lead dislocations (17.6% of all included). CONCLUSION: In patients with intractable chronic migraine treated with high-cervical SCS, pain and quality of life significantly improved, warranting further research.